Hawaii’s QUEST Expanded Access Recognized Nationally

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HONOLULU –In recognition of the 2009 statewide implementation of QUEST Expanded Access (QExA) by the State Department of Human Services (DHS), the Center for Health Care Strategies (CHCS) has identified Hawai‘i as one of five innovative states with demonstrated expertise in managed care approaches to long-term care.

Hawai‘i was recognized in the CHCS report: Profiles of State Innovation: Roadmap for Managing Long-Term Supports and Services.


This roadmap is part of a series developed by CHCS to help Medicaid agencies nationwide design more effective models for long-term care delivery. The CHCS report identifies state best practices for:

  • Rebalancing programs to provide more home- and community-based options instead of institutional care;
  • Designing managed long-term care programs; and
  • Integrating care for adults who are dually eligible for Medicare and Medicaid.

Hawai‘i was one of five states (including Arizona, Tennessee, Texas and Wisconsin) identified by CHCS as “true pioneers” in designing innovative approaches to delivering care to the elderly and adults with disabilities.

“QExA is an important step forward for Hawai’i, because our elderly and disabled Medicaid clients for the first time are receiving coordinated and comprehensive care,” said DHS Director Lillian Koller. “Through QExA, they are receiving timely access to high-quality medical treatment that will improve their health outcomes and their quality of life.”

Specifically, Hawai‘i was recognized for its transparency and intensive communication with key lawmakers, stakeholders and the public at least two months before the go-live date for QExA.

The report also acknowledged the implementation of a QExA Advisory Committee, which included advocates for the developmental disabilities community, provider associations, state agencies, medical educators, family organizations, and faith-based groups.

CHCS also recognized the addition of a needs-based assessment system, service coordinators and an ombudsman, which are all services provided to meet customer needs.

The report also spotlighted Hawai‘i’s focus on overseeing provider network adequacy to ensure access to care through a patient-oriented approach.

The report says DHS built in many reporting requirements for health plans to demonstrate that they provide all medically necessary care.

In addition, Hawai‘i was praised as a national role model for its efforts to decrease institutional care and employ family members as a critical part in reinforcing the traditional value of family-centered care.

QExA provides comprehensive and coordinated managed care for about 40,000 low-income seniors and disabled persons.

The full report can be viewed at


Submitted by Toni Schwartz of DHS